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PCOS & Fatigue

PCOS & Fatigue?noresize

If you have PCOS and feel chronically fatigued (a.k.a overtired), you may be surprised to know that PCOS and fatigue are actually related. In fact, fatigue is one of the leading symptoms reported among women with PCOS. There are many reasons why people experience fatigue. We lead hectic, busy lives, so it can be easy to down-play. If you are experiencing exhaustion on a regular basis, you may want to consider these three specific linkages to your chronic fatigue:

Potential Causes for PCOS Fatigue:

Iron Deficiency

Iron transports oxygen throughout your body, so when your iron levels are low, your body may feel rundown and extremely tired.  Due to hormone imbalance and/or heavy menstrual cycle (typical symptom of PCOS), iron deficiency is common.  Women with PCOS can suffer from heavy or irregular uterine bleeding for numerous reasons, including overgrown tissue inside the uterus. 

Heavy bleeding associated with these menstrual disturbances can increase a woman’s risk of iron deficiency. Check with your doctor to monitor your iron levels before adding in any supplementation.

Vitamin B12 Deficiency

Vitamin B12 plays an essential role in blood cell formation, cell metabolism, nerve function and DNA production. Adequate B12 levels also help maintain energy. Your body generally does a great job at storing B12; however, certain medicines can deplete B12 storage.

For example, metformin and certain birth control pills may be a culprit. These medications can interfere with the Vitamin B12 absorption. Common symptoms in those with a vitamin B12 deficiency include mood changes, fatigue, numbness or tingling in the arms, legs, fingers and feet. Weakness and fatigue are very common symptoms of vitamin B12 deficiency because your body does not have enough B12 to make red blood cells to transport oxygen throughout the body.

Insulin Resistance

With a PCOS diagnosis, insulin resistance may also become an issue. Insulin resistance is what happens when your cells stop responding to insulin… which increases blood sugar levels and forces your pancreas to pump out even more insulin. Also, if you eat high carbohydrate meals, your body may over-produce insulin, which is then quickly followed by a blood sugar crash…and (you guessed it) extreme fatigue.

Have You Downloaded the PCOS nutrition Guide?

A few ways to combat PCOS and fatigue include:


This may seem like an obvious answer, but adequate sleep helps manage your insulin levels. Good quality sleep helps every system in your body function at its best.  When you get less than 5 hours of sleep, your body may produce more cortisol (the “stress hormone”). When you experience stress, your adrenal glands release cortisol into the body, which temporarily increases blood sugar levels. This gives you a boost of energy needed to perform in stressful situations – but it’s only your body trying to protect you. In order to reduce the release of cortisol and blood sugar spikes, aim for 7-9 hours of sleep each night.


Frequently, low energy is related to the foods you eat. Eating a diet high in simple or highly refined carbohydrates may cause you to feel exhausted because of your blood sugar response. Add whole-food starches like brown rice, quinoa or sweet potatoes with higher fiber to slow digestion. Slow digestion prevents an insulin spike (meaning no blood sugar crash!).  One way to combat swinging insulin levels is to practice a PCOS-friendly diet – eating a protein at every meal, including slow-digesting carbohydrates, and avoiding dairy when possible.

Caffeine also stimulates your adrenals to produce more cortisol. While you might feel like you can’t function without coffee in the morning, it may be hurting more than it’s helping.


Your body is nearly 70% water and needs adequate hydration in order to provide consistent energy all day long. If you feel thirsty, it may mean you are already slightly dehydrated, which can cause fatigue. A good rule of thumb is to drink 64 oz of water daily (though everyone’s needs are different depending on height, weight, age etc).

Next Steps

It can be very frustrating to do everything right and still feel tired. PCOS fatigue can be caused by insulin resistance, stress, sleep programs and/or vitamin deficiency.  Hormone imbalance is a huge reason you may be feeling exhausted and anxious. Once you figure out the root cause of your fatigue, you can take the steps to fix the problem and regain your energy. Taking the proactive steps to reduce symptoms of PCOS can ultimately improve your health, mood and energy levels.

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